Estramustine (Emcyt®) (“es tra MUS teen”)

How this drug is given: By mouth

Purpose: To kill cancer cells in prostate cancer

How to take by mouth • Swallow each tablet whole; do not crush or chew them. If you are unable to swallow the tablet, the pharmacist will give you specific instructions.

• Take on an empty stomach, at least 1 hour before or 2 hours after eating.

• Do not take with milk, milk products, or calcium-rich food or drugs (including antacids that contain calcium; for example, Tums®).

• If you miss a dose, take as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double dose. Storage • Store this medicine in the refrigerator. Keep this medicine in its original container, out of reach of children and pets.

Things that may occur during treatment 1. Mild to moderate nausea, vomiting, and loss of appetite may occur. Drugs to help with this may be given to you.

2. Loose stools or diarrhea may occur. You may take loperamide (Imodium A-D®) to help control diarrhea. You may buy this at most drug stores. It is also important to drink more fluids (water, juice, sports drinks). If these do not help within 48 hours, tell your doctor or nurse.

3. Swelling or tenderness of the breast may occur.

4. Your body may not be able to get rid of extra fluid. This is called edema. You may notice some swelling in your arms or legs.

Pharmacy and Therapeutics Committee Approved Approval Date 08/10 Last Revised 06/12 Estramustine Page 2 of 2

5. You may have a cough or shortness of breath. New or worsening cough, or shortness of breath should be reported to your doctor or nurse.

6. Leg cramping can occur. Stretching before bed and drinking plenty of fluids may help.

7. You may be at an increased risk of blood clots. If you have pain, swelling or and/or warmth in one leg, let your doctor or nurse know right away.

8. Fertility: • This drug could be harmful to an unborn baby. Therefore women should not become pregnant while receiving this drug. You can ask your doctor for more information about avoiding pregnancy. • Men receiving this drug may become sterile and unable to father a baby. • For women, your period (menstrual cycle) may not be regular for a while or may stop completely and you may not be able to get pregnant. • If you are concerned about any of this, please talk with your doctor or nurse.

The above information includes some, but not necessarily all, of the possible side effects of this medication. The side effects in this teaching sheet may not be the same ones you experience. Your side effects may be different, depending on how often you receive treatment (your schedule) and how much you receive each time (your dosage). Side effects may also vary if you take other medications. Please talk with your doctor or nurse if you have questions about possible side effects you may experience. This document should not take the place of conversations with members of your health care team.

If you experience any significant change in your health during or after treatment, contact a member of your health care team right away.

Managing your oral chemotherapy schedule at home can be challenging. To help you with this, consider using tools to help you keep track of your schedule and any side effects you may have. You can find these tools online at www.dana-farber.org/OralChemoDiary.

THIS SPACE RESERVED FOR WRITTEN COMMENTS OR NOTES FOR THE PATIENT AND FAMILY:

Pharmacy and Therapeutics Committee Approved Approval Date 08/10 Last Revised 06/12